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Ashish Kelwa 
B.tech Bioinformatics 
III Sem
INTRODUCTION 
Mycobacterium, genus of rod-shaped bacteria of the 
family Mycobacteriaceae (order Actinomycetales), the 
most important species of which, M. tuberculosis and 
M. leprae, cause tuberculosis and leprosy, respectively, 
in humans. M. bovis causes tuberculosis in cattle and in 
humans. Some mycobacteria are saprophytes (i.e., they 
live on decaying organic matter), and others are 
obligate parasites. Most are found in soil and water in a 
free-living form or in diseased tissue of animals. 
Streptomycin, rifampin, and species-specific 
antimicrobial agents have had some success in treating 
Mycobacterium infections. Mycobacterium leprae
Classification 
 Mycobacteria are slender rods that sometimes show branching, filamentous 
forms resembling fungal mycelium. 
 The genus Mycobacterium contains three groups: 
o Obligate parasites 
o Opportinistic pathogens 
o Saprophytes
Obligate Parasites 
• Mycobacterium tuberculosis complex 
Contains M. tuberculosis, M. bovis, M. africanum, M. microti, M. canetti, M. caprae 
and M. pinnipedii 
• Mycobacterium leprae
Opportunistic Pathogens 
Non-tuberculosis mycobacteria (NTM) 
This group contains mixed group of isolates from diverse sources: birds, cold-blooded 
and warm-blooded animals, from skin ulcers, and from soil, water and other 
environmental sources. 
They are opportunistic pathogens and can cause many types of disease.
Pathogenesis 
Source of infection: 
 Open case of pulmonary tuberculosis 
Mode of infection 
 Direct inhalation of aerosolized bacilli contained in the droplet nuclei of expectorated sputum. 
 Infection also occurs infrequently by ingestion for example, through infected milk, and rarely 
by inoculation.
Transmission of M.tuberculosis 
Millions of tubercle bacilli in lungs (mainly in cavities). 
Coughing projects droplet nuclei into the air that contain 
tubercle bacilli. 
One cough can release 3,000 droplet nuclei. 
One sneeze can release tens of thousands of droplet nuclei
Infection 
The initial infection with M. tuberculosis is referred to as a 
 Primary infection 
Subsequent disease in a previously sensitized person, either from an exogenous source or 
by reactivation of a primary infection is known as 
 Postprimary tuberculosis 
Both forms exhibit quite different pathological features.
Difference b/w Primary and Postprimary 
tuberculosis 
Characteristics Primary Postprimary 
Site Any part of 
lung 
Apical region 
Local lesion Small Large 
Cavity formation Rare Frequent 
Lymphatic 
involvement 
Yes Minimal 
Infectivity* Uncommon Usual 
Local spread Uncommon Frequent 
*Pulmonary cases
Immunology 
Tubercle bacilli do not contain or secrete a toxin. 
The exact basis of their virulence is not understood, but 
seems to be related to their ability to survive and multiply 
in macrophages. 
Humoral immunity appears to be irrelevant. 
The only specific immune mechanism effective is the CMI.
The key cell is the activated CD4+ helper T cell which can develop along two 
different paths: The Th1 and Th2 cells 
Th1 dependent cytokines activate macrophages, resulting in protective immunity 
and containment of the infection 
Th2 cytokines induce delayed type hypersensitivity (DTH), tissue destruction and 
progressive disease
Laboratory Diagnosis 
Specimen Collection 
Type of lesion Specimen 
Pulmonary tuberculosis Sputum 
 Early morning sputum samples should be collected for 3 
consecutive days in a sterile container 
 In case of renal tuberculosis, 3-6 morning urine samples 
should be collected 
Laryngeal swabs or 
bronchial washings 
Gastric lavage 
Renal tuberculosis Urine 
Tuberculosis meningitis CSF
Direct Microscopy 
 Ziehl-Neelsen staining (hot staining method) 
 Kinyoun’s method (cold staining method) 
 Acid fast bacilli resist decolourisation with acid and alcohol 
once they have been stained with carbolfuchsin. 
 AFB appear as pink, long, slender bacilli with beaded 
appearance. 
Ziehl-Neelsen Staining
Fluorescent staining by Auramine O or auramine rhodamine 
Mycobacterium spp. will fluoresce yellow against dark background under fluorescent microscope
Culture 
 Concentrated specimen is inoculated 
on Lowenstein – Jensen’s medium and 
incubated at 370C for 2 – 8 weeks 
 Colonies appear as buff coloured, dry, 
irregular colonies with wrinkled surface 
and not easily emulsifiable 
(Buff, rough and tough colonies) 
 Colonies are creamy white to yellow colour 
with smooth surface and easily emulsifiable
Detection of antibodies 
 Various methods such as enzyme linked immune sorbent assay (ELISA), radio immunoassay (RIA), latex 
agglutination assay have been employed for detection of antibodies in patient serum. 
 However, diagnostic utility of these methods is doubtful. 
 WHO has recommended that these tests should not be use for diagnosis of active tuberculosis.
Mycobacterium

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Mycobacterium

  • 1. Ashish Kelwa B.tech Bioinformatics III Sem
  • 2. INTRODUCTION Mycobacterium, genus of rod-shaped bacteria of the family Mycobacteriaceae (order Actinomycetales), the most important species of which, M. tuberculosis and M. leprae, cause tuberculosis and leprosy, respectively, in humans. M. bovis causes tuberculosis in cattle and in humans. Some mycobacteria are saprophytes (i.e., they live on decaying organic matter), and others are obligate parasites. Most are found in soil and water in a free-living form or in diseased tissue of animals. Streptomycin, rifampin, and species-specific antimicrobial agents have had some success in treating Mycobacterium infections. Mycobacterium leprae
  • 3. Classification  Mycobacteria are slender rods that sometimes show branching, filamentous forms resembling fungal mycelium.  The genus Mycobacterium contains three groups: o Obligate parasites o Opportinistic pathogens o Saprophytes
  • 4. Obligate Parasites • Mycobacterium tuberculosis complex Contains M. tuberculosis, M. bovis, M. africanum, M. microti, M. canetti, M. caprae and M. pinnipedii • Mycobacterium leprae
  • 5. Opportunistic Pathogens Non-tuberculosis mycobacteria (NTM) This group contains mixed group of isolates from diverse sources: birds, cold-blooded and warm-blooded animals, from skin ulcers, and from soil, water and other environmental sources. They are opportunistic pathogens and can cause many types of disease.
  • 6. Pathogenesis Source of infection:  Open case of pulmonary tuberculosis Mode of infection  Direct inhalation of aerosolized bacilli contained in the droplet nuclei of expectorated sputum.  Infection also occurs infrequently by ingestion for example, through infected milk, and rarely by inoculation.
  • 7. Transmission of M.tuberculosis Millions of tubercle bacilli in lungs (mainly in cavities). Coughing projects droplet nuclei into the air that contain tubercle bacilli. One cough can release 3,000 droplet nuclei. One sneeze can release tens of thousands of droplet nuclei
  • 8. Infection The initial infection with M. tuberculosis is referred to as a  Primary infection Subsequent disease in a previously sensitized person, either from an exogenous source or by reactivation of a primary infection is known as  Postprimary tuberculosis Both forms exhibit quite different pathological features.
  • 9. Difference b/w Primary and Postprimary tuberculosis Characteristics Primary Postprimary Site Any part of lung Apical region Local lesion Small Large Cavity formation Rare Frequent Lymphatic involvement Yes Minimal Infectivity* Uncommon Usual Local spread Uncommon Frequent *Pulmonary cases
  • 10. Immunology Tubercle bacilli do not contain or secrete a toxin. The exact basis of their virulence is not understood, but seems to be related to their ability to survive and multiply in macrophages. Humoral immunity appears to be irrelevant. The only specific immune mechanism effective is the CMI.
  • 11. The key cell is the activated CD4+ helper T cell which can develop along two different paths: The Th1 and Th2 cells Th1 dependent cytokines activate macrophages, resulting in protective immunity and containment of the infection Th2 cytokines induce delayed type hypersensitivity (DTH), tissue destruction and progressive disease
  • 12. Laboratory Diagnosis Specimen Collection Type of lesion Specimen Pulmonary tuberculosis Sputum  Early morning sputum samples should be collected for 3 consecutive days in a sterile container  In case of renal tuberculosis, 3-6 morning urine samples should be collected Laryngeal swabs or bronchial washings Gastric lavage Renal tuberculosis Urine Tuberculosis meningitis CSF
  • 13. Direct Microscopy  Ziehl-Neelsen staining (hot staining method)  Kinyoun’s method (cold staining method)  Acid fast bacilli resist decolourisation with acid and alcohol once they have been stained with carbolfuchsin.  AFB appear as pink, long, slender bacilli with beaded appearance. Ziehl-Neelsen Staining
  • 14. Fluorescent staining by Auramine O or auramine rhodamine Mycobacterium spp. will fluoresce yellow against dark background under fluorescent microscope
  • 15. Culture  Concentrated specimen is inoculated on Lowenstein – Jensen’s medium and incubated at 370C for 2 – 8 weeks  Colonies appear as buff coloured, dry, irregular colonies with wrinkled surface and not easily emulsifiable (Buff, rough and tough colonies)  Colonies are creamy white to yellow colour with smooth surface and easily emulsifiable
  • 16. Detection of antibodies  Various methods such as enzyme linked immune sorbent assay (ELISA), radio immunoassay (RIA), latex agglutination assay have been employed for detection of antibodies in patient serum.  However, diagnostic utility of these methods is doubtful.  WHO has recommended that these tests should not be use for diagnosis of active tuberculosis.

Editor's Notes

  1. An obligate parasite is a parasitic organism that cannot complete its life cycle without exploiting a suitable host. If an obligate parasite cannot obtain a host it will fail to reproduce.
  2. Cerebrospinal fluid